The faces of public health: Meet Sandra Vesco, infectious disease manager and contact tracer

This story is the second in a series that looks at how public health care officials in Windsor are coping with the COVID-19 pandemic. CBC News spoke with the people who work at the Windsor-Essex County Health Unit and discussed the moments that made them proud to be on the front lines, the sacrifices they made to help contain the spread of a deadly virus and the frustrations they felt. Read the first one here. 

Sandra Vesco spent most of the summer playing detective. 

She spoke with people who tested positive for COVID-19 in Windsor-Essex and then was tasked with tracking down every person with whom they had close contact. 

It meant having long, personal conversations with strangers who just found out they had contracted a sometimes-deadly virus and needed to isolate themselves from family and friends for weeks. 

This investigative work became part of her role as the manager of Windsor-Essex County Health Unit's infectious disease department when COVID-19 hit the region. 

Working at the nerve centre of the public health unit from day one, she soon trained new hires and managed response plans. Vesco spoke with CBC News about how she managed the work, along with self-isolating from her own family,  and the mantra she repeated through it all: just keep swimming.

On the work

My whole world revolves around COVID at this point. It's just something I've accepted. At work it's COVID, I turn on the TV it's COVID, talk to a friend it's COVID. My life has been consumed with COVID — and rightly so, it's just the position that I'm in, and there is no escaping that.

Our day-to-day here became much like a command centre and it almost, at times, felt like we were just fighting a battle. And we were — and we still are, fighting the virus is our battlefield.

Picture it like Wall Street, where you have many things happening. You have the cases listed on the board and you're assigning cases. And this case belongs to that one because this one is a household contact, or this one is related because they work at the same workplace. We would assign cases to nurses based on the linkages that we found. 

There were moments of extreme heightened pressure and there were lulls. And it has been that way.

In the very beginning, I would equate this to watching a roller coaster go up, where you're kind of like tick, tick, tick. And we were watching. We were watching and waiting for cases. They were trickling in. And then once they came, the real roller coaster began. And we've been kind of on a steady uphill with a few dips and lulls in cases and back up hill again. 

A typical day

Every day we receive notification from the lab that someone's been tested and that they've tested positive for COVID. Once this comes in, we have to assign this investigation to a nurse and we call these nurses case investigators.

And these investigators act much like detectives.

Initially when we call, we're reviewing their health history. We're making sure that they're isolating. We're talking to them about where they have been and then making sure that we identify any contact that they could have come in contact with, and that's really critical that we contain all of those contacts so that we avoid spreading this virus further in our community.

If we're not able to make those links and understand where the spread is, then we wouldn't be able to contain. And that's our primary goal, keeping those numbers down, flattening the curve for our area. 

A typical contract tracing call

When we're calling cases ... [we're] understanding their health information, where they've been, providing a lot of education to the person, calming their concerns and their fears.

So the phone calls are not very quick at all. They can be anywhere from a half an hour to an hour to several hours, depending on the need that the individual has. And then, of course, if the individual has a workplace that they attend or children that attend school, there are other questions and concerns that come up in that conversation that may lead to longer discussions. 

On her frustrations

When we would make our calls and the nurses would alert the managers to suspicions of people not isolating or people gathering when they shouldn't be or things of that nature, it was very frustrating.

Having those conversations with the individuals to help them understand that it's important to comply with isolation, wasn't easy. They didn't really get the risk that they were posing to our community.

They may be well, but we do have some people in our community who are vulnerable and their risk to those people is great. So they're going into our community and possibly infecting others who can't fight the infection as easily as they can.

So I have to say that that was definitely challenging. Sometimes those were lengthy discussions. Most times we were on the same page. 

The silver lining

I have to say, I was really pleased with how people stepped up to the plate. We went from working regular Monday to Friday shift days to seven days a week, two shifts, morning and afternoon, weekends, overtime, long hours. 

But the reason they're staying is to help. "I need to finish my interview with this patient. I need to make sure that they understand. I need to make sure that they have the resources they need or this individual is short of breath and I think we need to call 911 and help them." Those things really stick out. It was the going above and beyond ... Having more people than you need to step up to do that, it was just like amazing to hear and to see that people were ready and willing to serve their community. 

On family 

We had to send nurses out, including myself, to test people in their homes ... We felt that we needed to isolate from our families ... so there was a moment in time where I separated from my children, my small children for two months. 

They stayed with their dad and I had to be apart, and I didn't hesitate because I knew that they'll understand one day that we're a part of something and my community needs me ... So I just want to say that we've all made sacrifices and I hope that the community can continue to see that what we're doing is for them and that the things that they're doing, online schooling ... or staying separated and not gathering for holidays, I hope that they realize that the reason for this is for the greater good. 

I did take the chance and have my children come back to live with me. And it was, you know, at first I was like, should I hug them? But eventually it became more commonplace and we became our own little bubble ... and I have to say, they were so supportive.

This interview has been edited for clarity and length.